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Home My WebLink About05-29-08 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRISBURG, PA 17128-0601 REV-1162 EX(11-96) RECEIVED FROM: PENNSYLVANIA INHERITANCE AND ESTATE TAX OFFICIAL RECEIPT NO. CD 009803 DILLER THELMA 6046 EDWARD DRIVE MECHANICSBURG, PA 17050 ACN ASSESSMENT CONTROL NUMBER AMOUNT __n____ fold 08118167 $11.97 ESTATE INFORMATION: SSN: 174-20-5882 FILE NUMBER: 2108-0587 DECEDENT NAME: SMITH AUDREY DATE OF PAYMENT: OS/29/2008 POSTMARK DATE: OS/28/2008 COUNTY: CUMBERLAND DATE OF DEATH: 02/28/2008 TOTAL AMOUNT PAID: $11.97 REMARKS: CHECK# 2519 SEAL INITIALS: CJ RECEIVED BY: GLENDA FARNER STRASBAUGH REGISTER OF WILLS REGISTER OF WILLS COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF REVENUE BUREAU OF INDIVIDUAL TAXES DEPT. 280601 HARRIS8URG, PA 17128-0601 ~;" ~. FILE ACN DATE NO. 21 -D~..... ()~~7 08118167 05-05-2008 INFORMATION NOTICE - AND (TAXPAYER RESPONSE RE'i- 2008 MAY 29 PH I: 3l+ TYPE OF ACCOUNT [Xl SAVINGS D CHECKING D TRUST D CERTIF. EST. OF AUDREY SMITH S.S. NO. 174-20-5882 DATE OF DEATH 02-28-2008 COUNTY CUMBERLAND ("I Ef)'{ (,r- . i__. I d \ ~), r pi, "f'., '~ t'(\ lOT OH n/".i\ ,J ..."jL, tl CUt. P;\ REMIT PAYMENT AND FORMS TO: REGISTER OF WILLS CUMBERLAND CO COURT HOUSE CARLISLE, PA 17013 THELMA DILLER 6046 EDWARD DR MECHANICSBURG PA 17050 MEMBERS 1ST FED CREDIT UNION has provided the Department with the information listed below which has been used in calculating the potential tax due. Theil' records indicate that at the death of the above decedent, you were a joint owner/beneficiary of this account. If you feel this information is incorrect, please obtain written correction from the financial institution, attach a copy to this form and return it to the above address. This account is taxable in accordance with the Inheritance Tax Laws of the Commonwealth of Pennsylvania. Questions May be answered by calling (717) 787-8327. COMPLETE PART 1 BELOW ~ ~ ~ SEE REVERSE SIDE FOR FILING AND PAYMENT INSTRUCTIONS Account No. 2994- 00 Account Balance Percent Taxable Amount SUbject to Tax Tax Rate Potential Tax Due PART ill Date Established 09-08-1994 To insure proper credit to your account, two (2) copies of this notice must accompany your paYMent to the Register of Wills. Make check payable to: "Register of Wills, Agent". x 531.77 50.000 265.89 .045 11.97 TAXPAYER RESPONSE NOTE: If tax pay.ents are made within three (3) .onths of the decedent's date of death, you .ay deduct a 5% discount of the tax due. Any inheritance tax due will become delinquent nine (9) months after the date of death. x [CHECK ] ONE BLOCK ONLY A. [] The above infor.ation and tax due is correct. 1. You .ay choose to reMit payment to the Register of Wills with two copies of this notice to obtain a discount or avoid interest, or you lIay check box "An and return this notice to the Register of Wills and an official assess.ent will be issued by the PA Department of Revenue. B. [] The above asset has been 01' will be reported and tax paid with the Pennsylvania Inheritance Tax return to be filed by the decedent's representative. C. [] The above information is incorrect and/or debts and deductions were paid by you. You must complete PART ~ and/or PART ~ below. PART If you indicate a different tax rate, please state your ~ relationship to decedent: TAX RETURN - COMPUTATION OF TAX ON JOINT/TRUST ACCOUNTS 1 2 3 X 4 5 6 7 X 8 LINE L Date Established 2. Account Balance 3. Percent Taxable 4. Amount Subject to Tax 5. Debts and Deductions 6. Amount Taxable 7. Tax Rate 8. Tax Due PART @J DATE PAID PAYEE DEBTS AND DEDUCTIONS CLAIMED DESCRIPTION AMOUNT PAID TOTAL (Enter on Line 5 of Tax Computation) $ Under penalties of complete to the b~S :::::>Of facts true, correct and b' <13 :)--S-" ()03~ DATE HOME ~ R E~)' ) 'I' i t' { \.\\\,\. .,: '\ ~,,~\ \' (()I); \ '\. \" \ ~, ~ 1'< ~i 1<:' \1' ,~f :J, " ~ ~ .:+. f~ U. \l ~ ..... , - ~ f'f! ;..-. ti ~ ( I: ~:: ~, F" :,. .~t~ .,,.., ..J: <~ " i:~: ~ .=Po< ... l-l . ..2 "0 e.o ;sa.6 . ~ ~ - "0 'a G ~ os -1,0-= ~"'"~ ;;>@~ . (Y) ""---- ~ f'-... ~~ --- ~~a . j I ~JJ \Ie; lJ.J,""("""'" -,. "'(1'" w ilJI..)J'--;b' '~I tJ -ifj ',I,,' ,':]-' I&V' _ ' / '(_ ,0') J ....... IL.. ~E;:t ~Jd 62 A VU Baaz 1-:', '\.,., 1./'._ '..,.-.,. J-- .- .- .- .- -- .- -- -:::: -- ('.1 iTl I') (,) .. !.+f I't". ..' .,.., I;;) ! .. -r"